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Sunday, April 28, 2013

Enough Already! Let's Tell the Stories

With all of the anecdotal and empirical evidence showing that in the trauma and recovery process...

active coping helps someone achieve a sense of personal control over the stressful aspects of the environment and one's emotions and appears to be associated with better adjustment compared to avoidance or disengagement from the stressful situation related to poorer adjustment overall (Baum, 2004)

confrontation and disclosure of stressful or traumatic events - in an (1) increasingly coherent, organized and detailed narrative, (2) acknowledging the good and the bad memories, (3) describing the event details and our subsequent feelings, (4) using positive emotion words and a moderate number of negative emotion words - leads to better physical/mental health outcomes and attachment security than the inhibition of any of this stuff (Theorists Pennebaker & Bowlby)

exposure therapy is the gold standard for anxiety and PTSD treatment with 30+ years of randomized control trials (the gold standard in intervention research) showing evidence of effectiveness (Chorpita, personal communication)

narrative exposure therapy (a re-telling of important lifetime events - both the good and the bad), even when conducted by trained lay counselors (sometimes refugees living in the refugee camps as well) in war-torn countries, has been shown to reduce PTSD symptoms in both adults and children (Robjant & Fazel, 2010)

Dr. Bessel van der Kolk, Harvard trauma researcher and author of The Body Keeps the Score, said that sooner or later the kid will have to tell the story (NCTSN.org podcast)

and that in the years following the death of my own mother, I felt compelled to tell the story over and over again with the only people who could stand it - other grieving daughters - and my dear family and friends.

I contend that discouraging active coping, disclosure and exposure is unscientific and potentially culturally insensitive as well as physically and emotionally harmful.